The number of uninsured Americans fell by 6.8 million
over the first two quarters of 2014, preliminary data from the
Centers for Disease Control and Preventions National Health
Interview Survey show. Some 12.2 percent of Americans were uninsured
in the first six months of 2014, the CDC data show, a 2.2 percentage-point
decline from 2013 and the lowest rate since the CDC first collected
these data in 1997. The uninsured rate has fallen by nearly a
quarter since peaking at 16.0 percent in 2010.

Over 214,000 doctors won't participate
in the new plans
under the Affordable Care Act analysis of a new survey by Medical
Group Management Association shows. It's about a quarter of the
total number of 893,851 active professional physicians reported
by the Kaiser Family Foundation.

Sadly, the key
issue that was barely discussed during the Obamacare debate (except
here when we proposed lowering the Medicare age to 55 and including
small children) was using Medicare as an alternative to subsidizing
further private insurance corporations. We were please, therefore,
to learn that Rick Weiland - in a tough race for SD Senate seat
- thought that Medicare should have been an option for everyone.

Sixteen million are expected to be helped due to
improvements in Medicaid and CHIP. As the Center on Budget Policy
and Prioritis puts it:

"The plan would expand
Medicaid up to 133 percent of the poverty line for all children
and adults younger than 65 who are lawfully residing in the United
States and not eligible for Medicare. This would mean that millions
of low-income parents, as well non-disabled low-income adults
who do not have dependent children (and who are generally ineligible
for Medicaid today except in a small number of states with waivers),
would become newly eligible for health coverage through Medicaid.
Medicaid is the most cost-effective way to provide comprehensive
and affordable coverage to people with very low incomes and thereby
ensure that the low-income uninsured gain coverage. "

THE MANDATE

The individual mandate
is unconstitutional.
As constitutional attorney David Rivkin has explained, it goes
far beyond the standard judicial excuse of regulating interstate
commerce: "What's unique is the mandate [is] imposed on
individuals merely because they live - not connected with any
economic activity, not because they grow something, make something,
compose something. Merely because they live. And this is absolutely
unprecedented." Even when the government decided to ban
drinking during Prohibition, it at least had the decency to pass
a constitutional amendment. If this provision is upheld in the
courts, nothing would prevent the government from, for example,
ordering people above a cetain BMI to buy memberships in private
health clubs and to attend them at least three times a week.

THE INDUSTRY SUBSIDY

By requiring new insurance from inefficient private providers
instead of through a government program, the administration is
subsidizing the insurance cabal by billions of dollars. Further,
even though the public option provision fell far short of what
it should have been, Obama made a back room deal with the industry
to knife it.

A comparison of
health care costs has found that 31 cents of every dollar spent
on health care in the United States pays administrative costs,
nearly double the rate in Canada. Americans spend $752 more per
person per year than Canadians in administrative costs, investigators
from Harvard and the Canadian Institute for Health Information
found. - Reuters

SUBSIDIES FOR CITIZENS

According to the Congressional Budget Office,
a family of four earning $54,000 in 2016, when the health legislation
is fully in effect, would be eligible for a subsidy of $10,100
to help defray the cost of insurance under the health legislation
being debated by the Senate. By then, one of the most popular
federal plans, a nationwide Blue Cross and Blue Shield policy,
is projected to cost more than $20,000. That could leave the
family earning $54,000, slightly more than the current median
household income, with monthly premium costs of more than $825.

THE STALL

An amazing number of provisions won't go into effect
for four to nine years. One of the problems with this is that
if, during this period, the GOP gains control of the Congress,
there is nothing to stop them from stalling these programs further.
In addition, the Democrats are playing an extraordinarily dangerous
political game - taking immediate credit for things that may
not happen for years to come. In fact, the first significant
benefits to anyone will not occur for four years according to
the CBO calculations.

For example, not until 2014 would employers
be banned from denying coverage or providing higher premiums
for women or older people.

Business Week: "A
higher Medicare payroll tax will be assessed on individuals who
make more than $200,000 a year or families with income of more
than $250,000. The reconciliation bill includes an additional
3.8 percent Medicare tax on unearned income such as dividends
on these high earners."

EMPLOYER MANDATE

Business Week: "If
an employer with more than 50 employees doesn't offer coverage
and has just one employee who qualifies for a new tax credit,
the company must pay a fee for every full-time employee on its
roster. The reconciliation bill raises the penalty to $2,000
from $750, though it subtracts the first 30 employees from the
calculation.

UNCONSTITUTIONAL BUDGET
COMMISSION

The legislation includes
a flagrantly anti-constitutional provision, as described by the
CBPP:

[] The legislation would
establish an Independent Payment Advisory Board to develop and
submit proposals to slow the growth of Medicare and private health
care spending and improve the quality of care. The President
would nominate the board's 15 members, who would require Senate
confirmation, for staggered six-year terms.

If the projected growth
in Medicare costs per beneficiary in 2015 and thereafter exceeded
a specified target level which it almost certainly would do in
many years the board would be required to produce a proposal
to eliminate the difference. The board could not propose increases
in Medicare premiums or cost-sharing or cuts in Medicare benefits
or eligibility criteria; it would focus on proposals for savings
in the payment and delivery of health care services.

The board's recommendations
would go into effect automatically unless both houses of Congress
passed, and the President signed, legislation to modify or overturn
them. If the board recommended changes that the President supported,
the President could veto any congressional attempt to block them,
and a two-thirds vote of both the House and Senate would be required
to override the veto.[]

This provision is contemptuous
of the basic concept of our constitutional government.

CUTTING MEDICARE COSTS

One of the big sleepers
in the bill is the plan to "institute efficiencies"
in Medicare programs. In fact, Medicare is far more efficient
than any private insurance plan in the country.

Consider this snippet from
CBPP: "The legislation would reduce annual payment updates
to hospitals, skilled nursing facilities, hospices, ambulatory
surgical centers, and certain other providers to account for
improvements in economy-wide productivity. It would also reduce
payments to home health agencies, skilled nursing facilities,
and inpatient rehabilitation facilities." And just what
will happen to service and its availability?

"[The plan] to cut Medicare to pay for an overhaul of the health
system would threaten the profitability of roughly one in five
hospitals and nursing homes over the next decade, according to
a new analysis by the government official responsible for monitoring
the popular health program." - Washington Post

OTHER PROVISIONS

CBPP - Within months, insurers
that offer coverage of policyholders' children (including in
existing plans) would be required to allow adult dependents younger
than 26 to be added to such coverage. In addition, new insurance
plans would be barred from excluding children's pre-existing
conditions from coverage and would have to cover certain preventive
services at no charge to enrollees.

Off the
Charts Health reforms Medicaid expansion has produced
significant state budget savings, two new reports covering five
states show. Savings are expected to continue  and grow
 in coming years. These reports provide strong evidence
that claims that the expansion will harm state budgets are misplaced.

Expanding
Medicaid saved Arkansas and Kentucky nearly $31 million and $26
million, respectively, in just the first six months of 2014,
according to a report prepared for the Robert Wood Johnson Foundation.
They expect to save $89 million and $84 million this fiscal year,
which ends June 30. Whats more, the report found that these
states will continue to accumulate savings that will cover all
costs related to the expansion through the end of the decade,
even as the federal share of those costs phases down from 100
percent to 90 percent by 2020.

Arkansas
and Kentucky have achieved these savings in areas available to
all states. For example, as more people have gained health insurance,
fewer have needed state-funded mental health and behavioral health
programs that serve the uninsured. And both states have moved
people who previously received care under specialized Medicaid
categories for disabled adults and women with breast and cervical
cancer into the expansions new eligibility group, for which
the federal government is paying the entire cost.

Connecticut,
New Mexico, and Washington State are also enjoying budget savings
from their Medicaid expansions, a separate report from the Kaiser
Family Foundation found.

In addition,
Arkansas, Kentucky, New Mexico, and Washington State are collecting
more revenue from taxes on the providers and managed care plans
that serve the newly insured, the reports show.

Carl Finamore,
Socialist Worker - The controversial law does contain some important
positives for regular folks. For example, it guarantees coverage
for everyone without tacking on higher premiums because of pre-existing
medical conditions and it requires annual free preventive-care
health checks for those on Medicare.

But five
years in, as critics continue to emphasize, the ACA still primarily
serves as a huge government marketing campaign for private insurance
companies, funneling millions of new customers with few if any
restrictions on ever-escalating prices.

"The
ACA built upon the flaws of our market-based system and, quite
predictably, is failing to contain costs and provide broad access
to affordable, quality health care. Corporate interests still
trump the common good in U.S. health care," wrote John P.
Geyman in a five-year ACA assessment appearing in the February
10 International Journal of Health Services.

Dr. Geyman
is not alone. Other very prominent scholars and caregivers agree
that ACA's reliance on private insurers is its downfall.

For example,
the developer of the cardiac defibrillator, Dr. Bernard Lown,
completely dismisses their role in providing quality care for
the simple fact that "like all businesses, their goal is
to make money."

In essence,
we still only get the care we can afford depending on which of
the thousands of plans we subscribe. Ability to pay is still
the big problem.

As a result,
medical bills remain the number one reason for personal bankruptcy
even though most of the petitioners have health insurance. For
the rest of us, it's not much better.

Roughly
40 percent of Americans have trouble paying medical bills, as
noted in an extremely detailed 2011 National Scorecard on U.S.
Health System Performance commissioned by the Commonwealth Fund.

And, though
many have found policies with affordable premiums, the report
also indicated that adults are likelier than those in other developed
countries to forgo care because of cost.

In the
past five years, according to a thorough 2015 Bloomberg View
review, the average price to see a primary care doctor has risen
20 percent. For a specialist, it's gone up 29 percent and for
outpatient surgery it's up 43 percent.

No wonder,
the article explains, 22 percent of people now say the cost of
getting care has led them to delay treatment for a serious condition.
That's the highest percentage since Gallup started asking in
2001. Another poll cited found as many as 16 million adults with
chronic conditions have avoided the doctor because of out-of-pocket
costs.

Washington
Post - The Obama administration announced an ambitious goal to
overhaul the way doctors are paid, tying their fees more closely
to the quality of care rather than the quantity.

Rather
than pay more money to Medicare doctors simply for every procedure
they perform, the government will also evaluate whether patients
are healthier, among other measures. The goal is for half of
all Medicare payments to be handled this way by 2018.

Mondays
announcement marks the administrations biggest effort yet
to shape how doctors are compensated across the health-care system.
As the countrys largest payer of health-care services,
Medicare influences medical care generally, meaning the changes
being initiated by the administration will likely be felt in
doctors offices and hospitals across the country.

Fewer
people skipped needed health care due to its cost or reported
trouble paying medical bills in 2014, a new survey finds. These
improvements, the first since the Commonwealth Fund began asking
these questions roughly a decade ago, came as health reforms
major coverage expansions took effect in 2014.

Among
the surveys findings:

The number
of people ages 19-64 without health insurance showed a statistically
significant drop for the first time in the history of the biennial
survey, from 36 million in 2012 to 29 million in 2014. The share
of the population without insurance fell from 19 to 16 percent.
The share of people who failed to get needed health care because
of cost fell from 43 percent in 2012 to 36 percent in 2014. This
means fewer people said they skipped a recommended test, didnt
fill a prescription, avoided visiting a doctor or clinic when
having a health problem, or failed to see a specialist for needed
follow-up care.
The number of adults who reported problems with medical debt
(such as difficulty paying bills) fell from an estimated 75 million
in 2012 to 64 million in 2014. The share of the population reporting
these problems fell from 41 to 35 percent.
Critics of health reform suggested it would harm young adults,
but the opposite appears to be the case. People ages 19-34 made
the biggest coverage gains of any age group between 2012 and
2014, with those with incomes below about $47,000 for a family
of four seeing the greatest improvement.

ELIZABETH
EDWARDS, THINK PROGRESS Senator John McCain's health plan is
based on the idea that everyone should be on their own to buy
their health insurance on the individual market. And it's an
approach fundamentally at odds with the point of health insurance:
that we share risks. People with preexisting conditions, like
McCain and myself, would pay much more for health insurance under
his health plan, if we could get coverage at all.

Insurance
companies have all sorts of characteristics they look at in order
to increase premiums, such as preexisting conditions, occupation,
age, and residence. But I hadn't realized that the McCain plan
would enable insurers to "rate-up" my insurance bill
for not only my status as a breast cancer patient, but also my
gender.

The ability
to become pregnant has long been understood as an excuse to charge
women more for health insurance (because, of course, men have
nothing to do with that particular health condition). But [a
David] Lazarus column . . . tells us that insurers are charging
women higher premiums even if pregnancy benefits are excluded.
Blue Shield of California (Blue Shield) is now charging woman
more in the individual market because:

"Our
egghead actuaries crunched the numbers based on all the data
we have about healthcare," explained Tom Epstein, a Blue
Shield spokesman. "This is what they found."

That women
get sicker than men?

"It's
all about the statistics," Epstein said. . .

Whatever
their reasoning, one thing is clear - they don't want to enroll
too many women:

"We
don't want to get a disproportionate share of high-risk people,"
added Epstein.

WASHINGTON
BUSINESS JOURNAL Current retirees will need tens or even hundreds
of thousands of dollars in savings to ensure that they can afford
health care after leaving the workplace. That is according to
new data from nonpartisan research firm EBRI. . .

For example, a married couple of two 65-year-olds retiring this
year would need current savings of $235,000 to have a 90 percent
chance of having enough cash to afford their health costs in
retirement. That's assuming the couple supplements Medicare with
subsidized insurance premiums from a former employer.

Couples
who have unsubsidized insurance from an old employer, on the
other hand, would need $376,000 in current savings for a 90 percent
chance of covering their costs. And a couple with individually
purchased insurance to supplement Medicare would need $635,000.

ROSE ANN
DEMORO, HUFFINGTON POST - Behind the escalating debate on the
health care between Senators Hillary Clinton and Barack Obama
on individual mandate -- she's for it, he's against it -- is
a critical policy battle that not only cuts across health care
reform but also the neo-liberal privatization dreams, the home
mortgage crisis, and the recession that is no longer looming,
it's here. . .

Banks
are already into health care in a big way, serving as a repository
for health savings accounts and other tax credit schemes so beloved
by the Bush administration and the Republican presidential candidates.
But the financiers would like more.

Enter
the neo-liberal think tanks and policy wonks and plans they hawk
to expand the reach of the market, especially the financial market,
in health care. Central to that approach is shotgun insurance,
forcing everyone not currently covered to buy health insurance
policies.

Compelling
people to buy insurance, however, is not the easiest sell. Big
insurers and HMOs have a well deserved bad reputation for heartless
denials of care - that's how they make money. And, it's pricey.
Premiums the past decade have gone up 87 percent, not to mention
the ever climbing bills for deductibles, co-pays, and a host
of other transaction fees.

The finance
industry is over the moon with this scheme.

For insurers,
it means millions of new customers marched into their offices
with the force of law. With no controls on costs, many consumers
will just add on more debt. That's a boon for the credit card
companies and other financial institutions, but a heavy new burden
on many of the same people now losing their homes or struggling
with other financial hardship. . .

To shroud
the colossal problems and the real story of who actually makes
out like bandits under this scheme, the proponents, including
some liberal policy experts, have dressed it up with poll-tested
rhetoric that mandatory insurance is "universal health care."

But "having"
insurance is not the same as being able to use it. You're only
being mandated to purchase the premiums; they're not mandating
the insurance companies to make sure you get the care you need.
Nor does "having" insurance protect you from financial
ruin.

It accelerates
the dismantling of group insurance plans with individuals forced
to go it alone in the individual market, and institutionalizes
risk and cost shifting on to the backs of individuals and families.

REUTERS
- France, Japan and Australia rated best and the United States
worst in new rankings focusing on preventable deaths due to treatable
conditions in 19 leading industrialized nations. If the U.S.
health care system performed as well as those of those top three
countries, there would be 101,000 fewer deaths in the United
States per year, according to researchers writing in the journal
Health Affairs.

Researchers
Ellen Nolte and Martin McKee of the London School of Hygiene
and Tropical Medicine tracked deaths that they deemed could have
been prevented by access to timely and effective health care,
and ranked nations on how they did. . .

MARK DUNLEA,
COMMON DREAMS - "Bold, new experiments in moving our state
to universal health care" have invariably withered away
over time, often in only a few years.

For instance,
the media coverage over the new "universal" health
care system in Massachusetts generally failed to mention similar
pronouncements from Governor Dukasis two decades previously that
fell apart in a few years. Because Massachusetts expanded its
subsidies for insurance premiums for low-income people, over
160,000 of those eligible signed up this year. But only 7% of
the nearly 250,000 who must buy unsubsidized insurance -- or
face a fine of $2,000 in 2008 -- purchased private health insurance
this year. Thus the plan will end its first year at least $147
million over budget, with Massachusetts preparing to cut payments
to doctors and hospitals and ramp up out-of-pocket costs for
patients. And nearly 500,000 in Massachusetts remain uninsured.
Yet the leading Democratic Presidential contenders now embrace
Massachusetts' mandate for individual purchase of health insurance.

Maine's
patchwork approach to universal health care - the Dirigo plan
- is not working. Nor have the plans in Vermont, Minnesota, Washington
and Oregon. Tennessee's noteworthy TennCare program to help the
poor and uninsured is in the process of being dismantled. NY
has added targeted programs such as Child Health Plus and Family
Health Plus yet more than 5 million New Yorkers annually lack
health insurance.

This fall
Vermont launched "Catamount Health," a plan to cover
all Vermonters by subsidizing private health insurance from MVP
and Blue Cross Blue Shield with a combination of tobacco tax
money, Medicaid money and new taxes on employers who don't offer
health insurance. But as the plan takes its first steps, the
inadequate insurance for those who have it, with soaring co-pays,
huge deductibles and unaffordable prescription drugs has put
the crisis in health care back into the legislative agenda for
2008, front and center. . .

Incremental
approaches evade the fundamental problems that are causing the
ongoing crisis in our health care system. Real change requires
addressing the entire structure of financing -- in which employer-based
private health insurance dominates. Without facing this, the
problem of costs cannot be solved. Most of the money spent on
health care in New York comes from government (federal and state)
spending, yet private health insurance dominates the system.
As Governor Spitzer has pointed out, NY's system of health care
financing is often not directly tied to the services being provided,
its complexity and irrationality a result of the backroom deal
making at the State Capitol.

Incremental
approaches have done little to nothing to control costs, while
adding more people to the system, thus causing more financial
strain on both the government and private sectors, especially
in bad economic times

DECEMBER
2007

MASSACHUSETTS
HEALTHCARE PLAN ALREADY FAILING

[From
a group of Massachusetts physicians]

MASSACHUSETTS
PHYSICIANS
- In 2006, our state enacted a law designed to extend health
coverage to virtually all state residents. Political leaders
in other states as well as several Democratic presidential candidates
have embraced this model.

Massachusetts'
law mandates that uninsured individuals must purchase private
insurance or pay a fine. The law established a new state agency
to ensure that affordable plans were available; offered low income
residents subsidies to help them buy coverage; and expanded Medicaid
coverage for the very poor. (Immigrants are mostly excluded from
these subsidized programs.) Moneys that previously funded free
care for the uninsured were shifted to the new insurance program,
along with revenues from new fines on employers who fail to offer
health benefits to their workers. In addition, the federal government
provided extra funds for the program's first two years.

Starting
January 1, 2008 Massachusetts residents face fines if they cannot
offer proof of insurance. Yet as of December 1, 2007 only 37%
of the 657,000 uninsured had gained coverage under the new program.
These individuals often feel well served by the reform in that
they now have health insurance. However, 79% of these newly insured
individuals are very poor people enrolled in Medicaid or similar
free plans. Virtually all of them were previously eligible for
completely free care funded by the state, but face co-payments
under the new plan. In effect, public funds for care of the poor
that previously flowed directly to hospitals and clinics now
flow through insurers with their higher administrative costs.

Among
the near poor uninsured (who are eligible for partial premium
subsidies) only 16% had enrolled in the new coverage. And barely
7% of the uninsured individuals with incomes too high to qualify
for subsidies had enrolled according to the official state figures.
Few can afford premiums for even the skimpiest coverage; the
lowest cost plan offered for a couple in their fifties costs
$8,200 annually, and carries a $2,000 per person deductible.

Moreover,
the state's cost for subsidies is running $147 million over the
$472 million budgeted for fiscal year 2007. Meanwhile, collections
from fines on employers who fail to provide coverage are 80%
below the original projections. The funding gap will widen in
future years as health care costs escalate and insurers raise
premiums. Already, state officials speak of making up the shortfall
by forcing patients to pay sharply higher co-pays and deductibles,
and by slashing funds promised to safety net hospitals.

While
patients, the state and safety net providers struggle, private
insurers have prospered under the new law, and the costs of bureaucracy
have risen. Blue Cross, the state's largest insurer, is reaping
a surplus of more than $1 million each day, and awarded its chairman
a $16.4 million retirement bonus even as he continues to draw
a $3 million salary. All of the major insurers in our state continue
to charge overhead costs five times higher than Medicare and
eleven-fold higher than Canada's single payer system. Moreover,
the new state agency that brokers private coverage adds its own
surcharge of 4.5% to each policy it sells.

A single
payer program could save Massachusetts more than $9 billion annually
on health care bureaucracy, making universal coverage affordable.
But because the 2006 law deepened our dependence on private insurance,
it can only add coverage by adding costs. Though politically
feasible, this approach is already proving fiscally unsustainable.
The next economic downturn will push up the number of uninsured
just as the tax revenues needed to fund subsidies fall.

The lesson
from Massachusetts is that we still need real health care reform:
single payer, non- profit national health insurance.

STEFFIE
WOOLHANDLER AND DAVID U. HIMMELSTEIN - In 1966 - just before
Medicare and Medicaid were launched - 47 million Americans were
uninsured. By 1975, the United States had reached an all time
low of 21 million without coverage. Now, according to the Census
Bureau's latest figures, we're back where we started, with 47
million uninsured in 2006 - up 2.2 million since 2005. But this
time, most of the uninsured are neither poor nor elderly.

The middle
class is being priced out of healthcare. Virtually all of this
year's increase was among families with incomes above $50,000;
in fact, two-thirds of the newly uncovered were in the above-$75,000
group. And full-time workers accounted for 56 percent of the
increase, with their children making up much of the rest.

The new
Census numbers are particularly disheartening for anyone hoping
for a Massachusetts miracle. In the Commonwealth, 651,000 residents
are uninsured, 65 percent more than the figure used by state
leaders in planning for health reform. Their numbers came from
a telephone survey done in English and Spanish. But that misses
people who lack a land-line phone - 43.9 percent of phoneless
adults are uninsured, according to other studies.

It also
skips over the 523,000 non-English speakers in Massachusetts
whose native language isn't Spanish (e.g. Portuguese, Chinese,
or Haitian-Creole), another group with a high uninsurance rate.
. .

Why has
progress been so meager? Because most of the promised new coverage
is of the "buy it yourself" variety, with scant help
offered to the struggling middle class. According to the Census
Bureau, only 28 percent of Massachusetts uninsured have incomes
low enough to qualify for free coverage. Thirty-four percent
more can get partial subsidies - but the premiums and co-payments
remain a barrier for many in this near-poor group.

And 244,000
of Massachusetts uninsured get zero assistance - just a stiff
fine if they don't buy coverage. A couple in their late 50s faces
a minimum premium of $8,638 annually, for a policy with no drug
coverage at all and a $2,000 deductible per person before insurance
even kicks in. Such skimpy yet costly coverage is, in many cases,
worse than no coverage at all. Illness will still bring crippling
medical bills - but the $8,638 annual premium will empty their
bank accounts even before the bills start arriving. Little wonder
that barely 2 percent of those required to buy such coverage
have thus far signed up. . .

Health
reform built on private insurance isn't working and can't work;
it costs too much and delivers too little. At present, bureaucracy
consumes 31 percent of each healthcare dollar. The Connector
- the new state agency created to broker coverage under the reform
law - is adding another 4.5 percent to the already sky-high overhead
charged by private insurers. Administrative costs at Blue Cross
are nearly five times higher than Medicare's and 11 times those
in Canada's single payer system. Single payer reform could save
$7.7 billion annually on paperwork and insurance profits in Massachusetts,
enough to cover all of the uninsured and to upgrade coverage
for the rest of us.

Of course,
single payer reform is anathema to the health insurance industry.
But breaking their stranglehold on our health system and our
politicians is the only way for health reform to get beyond square
one.

[Dr. Steffie
Woolhandler and Dr. David Himmelstein co-founded Physicians for
a National Health Program]

REUTERS
- More than one-third of the U.S. population under the age of
65 went without health insurance for all or part of the last
two years. . . The nonprofit Families USA group used data from
last month's U.S. Census Bureau report that found 47 million
Americans went without health insurance for all of 2006. Families
USA broke down that figure and calculated that 89.6 million people
under age 65 -- 34.7 percent -- went without health insurance
at some point during 2006-2007. It used a projection for the
remaining months of this year.

PRIVATIZED
MEDICAL INSURANCE SYSTEM RESULTS IN UP TO 18,000 DEATHS A YEAR

PROJECT
CENSORED - The Sonoma State University Institute of Medicine
estimates that as many as eighteen thousand Americans die prematurely
each year because they do not have health insurance. This figure
does not include those who die prematurely each year because
their insurers delay, diminish, or deny payment for promised
benefits. Reports about people who die unnecessarily from services
denied or delayed by insurance companies seldom receive broad
coverage in the corporate media. Lack of media coverage has led
to a nation of people uninformed about how national health and
disability policies are controlled by the private insurance industry
and how government regulators are powerless to do anything about
it.

http://www.projectcensored.org/HCDI_1007.pdf

SEPTEMBER
2007

JULY
2007

HOW
THE NY TIMES RIGS THE HEALTHCARE DEBATE

DEAN BAKER,
PROSPECT - The NYT had a piece on the health care plans being
put forward by the presidential candidates that seemed determined
to frame the issues in a set of caricatures, where Democrats
push for big government while Republicans like the market. It
makes this assertion at several points, at one point even telling
readers mockingly that "Democrats are competing furiously
among themselves over who has the bigger, better plan to control
costs and to approach universal coverage."

But is
this government/market distinction accurate? Do the Republicans
favor ending the subsidies for the private insurers operating
within the Medicare program that the Medicare Payments Advisory
Commission estimates at 12 percent per beneficiary? Isn't a government
subsidy a form of government intervention?

Do the
Republicans favor eliminating government granted patent monopolies
that raise the price of prescription drugs and medical supplies
to levels that are many times the free market price? Aren't government
imposed monopolies a form of government intervention?

In short,
the NYT piece is written entirely from the Republican perspective
in which the interventions they support, which have the effect
of redistributing income upward and making health care more expensive,
are disguised as being simply the natural workings of the market.
On the other hand, the efforts of the Democrats to restructure
the market to make it more workable (e.g. mandating coverage
to eliminate the problem of adverse section) are mocked as "big
government."

http://www.prospect.org/csnc/blogs/beat_the_press

HOW
DEMOCRATS, SEIU CON VOTERS ON SINGLE PAYER HEALTH CARE

CORPORATE
CRIME REPORTER - On Capitol Hill today, SEIU held a rally for
a couple of hundred health care workers. The group was addressed
by six Senators. . . We asked Dawn Lee, a spokesperson for SEIU,
whether SEIU supported HR 676 -- the single payer bill in the
House. She said SEIU takes no position on that bill.

SEIU does
not support single payer. At the SEIU rally, all spoke in favor
of "universal health care." That is code for keep the
insurance companies in the game. Single payer would take them
out.

Martese
Chism was at a similar rally in Chicago last month. Chism is
a registered nurse at Cook County Hospital in Chicago. She also
sits on the board of the California Nurses Association. . . Chism
was attending an SEIU rally in Chicago in support of Illinois
Governor Rod Blagojevich's "universal health care"
bill that would keep the insurance companies in the game.

Chism
says that the SEIU members who gathered for the rally were being
actively misled by SEIU. "SEIU members are being led to
believe that universal health care means free health care for
all -- single payer. . .

CNA president
Rose Ann DeMoro is a touch less subtle. "Rather than being
on the side of the workers, SEIU continues to be on the side
of the bosses," DeMoro told Corporate Crime Reporter. "And
it's a disgrace."

"And
the problem is that SEIU is giving cover to these Senators --
it makes them look like they are accomplishing something when
in fact they are accomplishing

http://www.counterpunch.org/ccr06262007.html

JUNE
2007

PUBLIC
RANKS HEALTHCARE AS SECOND MOST IMPORTANT ISSUE

KAISER
FOUNDATION - Health care remains the top domestic issue that
the public wants presidential candidates to address, trailing
only Iraq on the public's overall priority list, according to
the latest Kaiser Family Foundation Health tracking poll. The
June poll finds that 43% of adults cite Iraq as one of the most
important issues for presidential candidates to talk about, followed
by health care (21%). Iraq ranks first among Democrats, Republicans
and independents alike.

Health
care ranks second among Democrats and independents, while Republicans
rank immigration slightly ahead of health (20% vs. 18%). Immigration
rose sharply as an issue since March and ranks third overall
with 18% in the new poll, which was taken as media attention
focused on the Senate debate about immigration reform legislation.
The economy (13%) and gas prices (12%) follow.

The poll
also measures the public's perceptions of the presidential candidates
on health issues. To date, most people don't know or can't name
the candidate who they feel is placing the biggest emphasis on
health or the candidate who most matches their own views. Across
party identification, Sen. Hillary Clinton remains the candidate
that people are most likely to name as placing the biggest emphasis
on health care (23%) and as agreeing with their views (17%).
Sen. Barack Obama is in second place (9% on each question).

Looking
only at Democrats, one in three name Sen. Clinton (33%, compared
to 27% in March) as the candidate who comes closest to their
personal views on health care, compared to 15% who name Sen.
Obama (up from 8% in March) and 4% who name former Sen. John
Edwards (no change since March).

Few people
name any of the Republican candidates as placing the biggest
emphasis on health care, with 2% overall naming former New York
Mayor Rudy Giuliani.

When asked
what concerns them about rising health care costs, the poll found
people are twice as likely to cite having to pay higher premiums
and increased out-of-pocket costs (38%) as they are to say increases
in spending on government health insurance programs like Medicare
and Medicaid (18%) or increases in what the nation as a whole
spends on health (18%). A smaller share (13%) cite increases
in the health insurance premiums that employers pay to cover
their workers. These views vary little based on party identification.

MAY
2007

LACK
OF NATIONAL HEALTH INSURANCE MAY EXPLAIN WHY EUROPEANS ARE TALLER
THAN AMERICANS

SPIEGEL,
GERMANY - For years, researchers have been wondering why Americans
stopped growing. US citizens were among the tallest in the world
up until World War II. But since then, heights have stagnated
while Europeans have been getting taller and taller, with the
average American now between two and six centimeters shorter.
The correlation between wealth and height has long been understood,
the most recent example coming as Eastern Europeans shot up following
the collapse of communism. But why, in the richest country in
the world, should growth rates be stagnating?

A new
study published in the current issue of the Social Science Quarterly
by researchers from Princeton University in the US and the University
of Munich in Germany indicates that the difference may have to
do more with politics than biology. Specifically, the study,
which involved the statistical analysis of demographic and health
data collected between 1959 and 2002, concludes that the spotty
US health-care system and weak welfare net could explain why
Americans have stopped growing.

APRIL
2007

STUDY
FINDS CANADA'S HEALTH SERVICE BETTER THAN AMERICA'S

CANWEST NEWS SERVICE - Canada's health-care
system is as good or better than that of the United States and
is delivered at half the cost, new research suggests. A review
in the inaugural issue of online medical journal Open Medicine,
. . . found that while the United States spent an average of
$7,129 US per person on health care in 2006, compared with $2,956
US per person in Canada, more studies favored the latter country
in terms of morbidity and mortality.

They covered
a wide range of diseases and conditions including cancer, coronary
artery disease. . .

FEBRUARY
2007

GREEN
PARTY HITS DEMOCRATS FOR RUNNING FROM SINGLE PAYER HEALTHCARE

GREEN
PARTY - Green Party leaders have called on Congress to reject
health care reform plans that maintained corporate-based insurance
and HMO coverage, and urged passage of a single-player national
health insurance program. Greens were especially critical of
Sen. Hillary Clinton's (D-N.Y.) continuing role in obstructing
needed health care reforms. "Hillary Clinton should be banished
from the room when health coverage is discussed," said Rebecca
Rotzler, co-chair of the Green Party of the United States and
Deputy Mayor of New Paltz, New York. "Ms. Clinton's favoritism
towards major insurance companies undermined real health care
reform when her husband's administration crafted its managed-care
monstrosity in 1993. She and other Democrats remain at the top
of the list of recipients of contributions from insurance and
pharmaceutical lobbies.

"Hillary
Clinton, Barack Obama, John Edwards, and other prominent Democrats
are the greatest obstacle to universal health coverage. Except
for a few mavericks like Rep. John Conyers [D-Mich.], who has
regularly introduced single-payer bills, Democrats have joined
Republicans in favoring HMO and insurance corporations over guaranteed
publicly-financed quality health care for every American. It's
a safe bet that the 2008 Democratic nominee will -- like Bill
Clinton, Al Gore, and John Kerry before them -- follow the same
pattern," said Kat Swift, spokesperson for the National
Women's Caucus of the Green Party.

http://www.gp.org/newscenter.shtml

WHY
THE DEMOCRATS ARE SO COWARDLY ABOUT HEALTHCARE

CORPORATE CRIME REPORTER - The majority
of the American people want a single-payer health care system
- Medicare for all. The majority of doctors want it. A good chunk
of hospital CEOs want it. But what they want doesn't appear to
matter. Why?

Because
a single-payer health care plan would mean the death of the private
health insurance industry and reduced profits for the pharmaceutical
industry.

Presidential
candidates John Edwards, Barack Obama, Hillary Clinton, and Mitt
Romney and California Governor Arnold Schwarzenegger talk a lot
about universal health care. But not one of them advocates for
single-payer - because single-payer too directly confronts the
big corporate interests profiting off the miserable health care
system we are currently saddled with.

"Currently,
we are spending almost a third of every health care dollar on
administration and paperwork generated by the private health
insurance industry," said Dr. Stephanie Woolhandler, an
Associate Professor of Medicine at Harvard Medical School and
co-founder of Physicians for a National Health Program. "Countries
like Canada spend about half that much on the billing and paperwork
side of medicine. If we go to a single-payer system and are able
to cut the billing and paperwork costs of health care, that frees
up about $300 billion per year. That's the money we need to cover
the uninsured and then improve the coverage for those who have
private insurance but are under-insured."

"The
idea behind single-payer is you don't have to increase total
health care spending," Woolhandler said in an interview
with Corporate Crime Reporter. "You take the money we are
now spending but cut the administrative fat and use that money
to cover people."

None of
the declared Presidential candidates - with the exception of
Congressman Dennis Kucinich (D-Ohio) - is supporting single-payer.
Last year, Kucinich and Congressman John Conyers (D-Michigan),
introduced a single-payer bill, HR 676, which garnered support
of more than 75 members of the House. Woolhandler expects that
number to grow substantially this year.

And Woolhandler
says grassroots activists have been mobilizing at the state level.
"State single-payer organizations have been very active,"
she said. "Early in the process, you can get a lot of politicians
interested - they want to show up at your rallies to show support
for national health insurance. But as you get closer and closer
to actual passage of a law, it is harder to keep the politicians
on board.". . .

Woolhandler
called the universal health care law passed in Massachusetts
by Governor Mitt Romney "a hoax."

"The
core idea is the individual mandate - forcing uninsured people
to go out and buy insurance," Woolhandler said. "And
if they don't buy insurance, we are going to fine them. The first
year it is an $80 fine. The second year, it's half the value
of the lowest priced policy - we're talking about a $2,000 fine.
So, they are saying anyone who earns more than three times poverty
has to bear the entire price of a private insurance policy."

"Romney's
bill was written by Blue Cross," Woolhandler said. "Romney
was saying he was going to offer health insurance starting at
$200 a month. And of course, that was a hoax. No insurance policy
in Massachusetts comes in at $200 a month. When Blue Cross was
asked to produce the policy, it turned out the policy was going
to cost $380 a month for a policy that had a $2000 deductible.
So, you are going to tell this poor bloke who is earning $29,400
a year that he has to go out and spend $4,000 a year on an insurance
policy. And if he gets sick, he doesn't even have any coverage
until he has spent $2,000. And that's not family coverage. That's
individual coverage."

Former
Senator John Edwards would have a Medicare-like system compete
with private insurance. "Edwards plan is not going to work,"
Woolhandler says flatly. "We know there is not going to
be fair competition between Medicare and the private plans. You
have to take on the private health insurance industry and tell
them - you are out of here. This is an entitlement program like
traditional Medicare or Social Security. We are going to get
the administrative efficiencies you get from running it as a
single program and use that to expand coverage. That's what you
have to do."

PHIL MATTERA,
CORPORATE RESEARCH PROJECT - In the late 19th Century European
countries began adopting government-funded social insurance plans,
but the U.S. failed to follow suit. When progressives made a
push in the 1910s there was opposition not only from corporate
interests but also from organized labor. AFL President Samuel
Gompers denounced national health insurance as a paternalistic
reform, fearing that its adoption would weaken the role of unions
in improving the living conditions of workers.

Consequently,
Americans both rich and poor continued to pay the vast majority
of medical costs out of pocket. That began to change in the 1930s.
While the Roosevelt Administration focused on retirement benefits
and unemployment insurance at the expense of health coverage,
physicians and hospitals struggling to survive the Depression
set up private group insurance plans to bolster demand for their
services. . .

In 1945
President Harry Truman proposed a national program establishing
a right to medical care and protection from the "economic
fears" of illness. But once again, opposition to government
involvement in healthcare emerged, this time reinforced by a
Cold War hysteria about "socialized medicine" stoked
by groups such as the American Medical Association.

As Truman's
plan went down to defeat, what grew in its place was a system
of employer-provided coverage, stimulated by aggressive bargaining
on the part of unions that had come to regard improving employee
benefits as a mission as important as increasing wages. . .

JACK E.
LOHMAN, WIS POLITICS - With the vast majority of the public --
and even the "non-healthcare" business leaders -- supporting
universal health care, why are our politicians not on board?

It makes
every bit of financial sense for businesses to get out of providing
health care and to turn it over to the most successful ever public-private
venture: Medicare. As a Medicare patient I have the same coverage
and physician choice I had before retiring. It's just managed
by a single payer: WPS in Madison.

Don't
think for a moment that single-payer is just another liberal
giveaway; it is the most fiscally conservative way possible of
financing health care for Wisconsin citizens. . .

Medicare-for-all
would do wonders for businesses by reducing labor costs by 15
percent; reducing worker compensation costs by 50 percent; and
cutting their and everybody else's auto insurance rates in half.
With these reduced costs they could add jobs in Wisconsin rather
than sending them to other countries. Health care would no longer
be a labor union negotiation and job changes would not involve
gaps in insurance, preexisting disease exclusions or delays,
or COBRA costs.

New jobs
would mean new tax revenues, increased property values, and less
unemployment, welfare and associated costs. New businesses will
move to Wisconsin and old businesses will keep their doors open.
And when businesses no longer have to add their health costs
to the price of their product, we will see lower prices at the
cash register and greater competitiveness against foreign products
that aren't burdened with health care costs.

Who wouldn't
like these single-payer benefits?

For one,
the insurance companies that are currently reaping 20-30 percent
of health care dollars won't like it a bit, and neither will
the politicians who receive campaign contributions from health
care interests. Nor will the board members that sit on both health
care and non-health care corporate boards, though business associations
that serve both factions owe it to the latter to sit this issue
out. The conflicts of interest that stand in the way of good
public policy abound.

If corporations
are not willing to provide employee health care at least equivalent
to Medicare, they should get out of the way and let the government
do it. We don't want their inadequately funded solutions or a
mish-mash of prohibitively expensive half-way measures. Or health
savings accounts that are time bombs waiting to explode in credit
card debt and bankruptcies.

Nor do
we want an incremental approach that will not cover all citizens
and is sure to fail. The public wants it done right and wants
it done now.

Think
about it. For the same amount of money we are paying to cover
85 percent of the public now, we could cover 100 percent under
a single-payer plan like Canada's -- but without the wait times.
Over 80 percent of Canadians prefer their system to ours. Their
life expectancy is two years longer and infant mortality 35 percent
less than ours -- mostly because everybody is insured under a
single-payer plan.

Canada
spends 10 percent of its gross domestic product on health care
while we spend 15 percent of GDP and get less for it. They cover
100 percent of their people and we cover 85 percent and that
is shrinking. Their administrative costs are 10 percent compared
to our 20-30 percent. They have no wait times for urgent procedures,
and those for elective care could be eliminated with a simple
increase in funding by 10 percent -- to 11 percent of GDP. While
their problem is funding, ours is systemic.

http://wisopinion.com/index.iml?mdl=article.mdl&article=6227

THROW
THE RASCALS OUT
http://www.ThrowTheRascalsOut.org

ROMNEY
STYLE UNIVERSAL HEALTHCARE: YOU BUY IT OR WE FINE YOU

ALICE DEMBNER, BOSTON GLOBE - More than 200,000
people with health insurance would have to buy additional coverage
to meet proposed minimum standards under the state's new health
insurance law, according to a count completed by insurers yesterday.
Most of the individuals do not have coverage for prescription
drugs or have drug coverage that is more restrictive than the
minimum proposed by the state board implementing the law. . .
Individuals would face a fine of about $200 next year and more
in future years, if they do not have insurance that meets the
standards.

"It's
very troubling," said Richard Lord, president of Associated
Industries of Massachusetts and a member of the Connector board.
"The new law was about expanding access for people without
any health insurance. I don't think we should be forcing people
who do have some coverage to spend more."

JANUARY
2007

SEIU,
DEMOCRATS JOINING IN HEALTHCARE CON

[It's
bad enough that centrist Democrats are falling for this, but
now the leading labor union SEIU has joined in support of phony
healthcare reform, backing a plan whose major attribute is that
it will continue to permit insurance companies to make huge profits.
Instead of a logical approach, such as expanding Medicare, a
disturbing consensus is developing around a convoluted, inadequate,
corporate-friendly mishmash and calling it - in one of the great
spin lies of our times - "universal healthcare." Steven
Pearlsein, a corporate columnist of the Washington Post, naturally
thinks it's swell]

STEVEN PEARLSTEIN, WASHINGTON
POST
- There, at the National Press Club, stood the president of the
Business Roundtable, representing the country's largest corporations;
the president of the Service Employees International Union, the
country's most vibrant union and one of its fastest-growing;
and the president of AARP, the formidable seniors lobby. They
put aside their usual differences to deliver a clear, simple
message to President Bush and congressional leaders of both parties:
We stand ready to give you the political cover you need for a
centrist, bipartisan fix for a broken health-care system. Or,
if you refuse, we stand ready to embarrass you and run you out
of office.

"Washington
is behind where the rest of the country is," said Andy Stern,
a labor leader. "Democratic leaders in Congress say this
is not the time. The White House has said now is not the time.
And we are saying, 'Now is the time.' "

Stern
and his new friends are right about one thing: Something's going
on.

SCHWARZENEGGER'S
HEALTHCARE CON

SHEILA
JAMES KUEHL, CHAIR CALIFORNIA SENATE HEALTH COMMITTEE, LA TIMES
- Schwarzenegger's plan. . . mandates that every individual have
insurance (not just every worker), yet it doesn't ensure that
coverage will be comprehensive and affordable. Schwarzenegger
also calls for increasing reimbursements paid to providers under
public programs by billions of dollars. . .

How does
he pay for it? Individuals and employers will contribute, but
employers are required to spend only 4% of payroll to insure
their employees, or contribute the same amount to a state fund.
This is not sufficient to purchase insurance for the working
uninsured, who will be required to have it. This means that the
governor's plan can at best provide high-cost, low-benefit plans
for many Californians; it limits what employers pay but not what
individuals must pay or what insurance companies can charge.

A portion
of the funding for the plan would also come from federal money
that is at this point only "hoped for." There also
would be a tax on providers, such as doctors and hospitals, and
the governor would redirect public money now spent on poor people
in hospitals to insurance companies. This would create an immediate
problem for hospitals, which are already closing because of inadequate
reimbursement from private insurance companies.

Finally,
the governor would adopt President Bush's plan for individual
health savings accounts by requiring employers to "allow"
employees to put away money, pretax, to pay for unreimbursed
medical expenses. These accounts effectively shift the costs
and liability of healthcare away from insurance companies and
onto consumers. Such a plan would not benefit people who are
already too strapped to meet current expenses, and it does nothing
to expand coverage or affordability.

GOP
GOVERNORS PROPOSING FAKE UNIVERSAL HEALTH COVERAGE

WITH THE
uncritical blessing of the media, GOP governors of Massachusetts
and now California have gotten away with calling required purchase
of private health insurance "universal health coverage."
Both the NY Times and the Washington Post gave this badly misleading
impression of what appears a conservative plan to derail growing
support for real universal coverage. Much as the right and the
media have used grossly distorted phrases like "Social Security
reform," the Schwarzenegger and Romney plan create their
universality not by providing coverage but by forcing citizens
to buy it from private insurers. This falls somewhere between
being a con and being unconstitutional, not unlike being told
you have to buy telephone service from a private vendor because
it's good for you.

LISA GIRION,
LA TIMES - Health insurers in California refuse to sell individual
coverage to people simply because of their occupations or use
of certain medicines, according to documents obtained by The
Times. Entire categories of workers - including roofers, pro
athletes, dockworkers, migrant workers and firefighters - are
turned down for insurance even if they are in good health and
can afford coverage, according to the confidential underwriting
guidelines of four health plans. . .

Such restrictions
are legal in California, and state regulators have no authority
to stop them. Health plans defend their restrictions as necessary
to keep premiums down. . .

At issue
is individual insurance, the type of coverage purchased by people
who do not have job-based group health benefits. Unlike group
coverage, individual insurance is granted case by case, meaning
in effect that health plans are free to choose whom to cover
and what to charge them.

NOVEMBER
2006

MYTHS
ABOUT SINGLE-PAYER HEALTHCARE

[From
the Hunger Action Network of New York]

Myth:
The government would dictate how physicians practice medicine.

In countries
with a national health insurance system, physicians are rarely
questioned about their medical practices (and usually only in
cases of expected fraud). Compare it to today's system, where
doctors routinely have to ask an insurance company permission
to perform procedures, prescribe certain medications, or run
certain tests to help their patients.

Myth:
Waits for services would be extremely long.

In countries
with NHI, urgent care is always provided immediately. Other countries
do experience some waits for elective procedures (like cataract
removal), but maintaining the US's same level of health expenditures
(twice as much as the next-highest country), waits would be much
shorter or even non-existent. Compared to most other countries
with universal health care, it is the US with the long waiting
times - especially for the tens of millions without health insurance.
There would be no lines under a universal health care system
in the United States because we have about a 30% oversupply of
medical equipment and surgeons, whereas demand would increase
about 15%

Myth:
People will over-use the system.

Most estimates
do indicate that there would be some increased use of the system
(mostly from the 42 million people that are currently uninsured
and therefore not receiving adequate health care), however the
staggering savings from a single-payer system would easily compensate
for this.

Myth:
Universal Health Care Would Be Too Expensive

The United
States spends at least 40% more per capita on health care than
any other industrialized country with universal health care.
Federal studies by the Congressional Budget Office and the General
Accounting office show that single payer universal health care
would save 100 to 200 billion dollars per year despite covering
all the uninsured and increasing health care benefits. The United
States spends 50 to 100% more on administration than single payer
systems. By lowering these administrative costs the United States
would have the ability to provide universal health care, without
managed care, increase benefits and still save money.

Myth:
A single payer system Would Result In Government Control And
Intrusion Into Health Care Resulting In Loss Of Freedom Of Choice

There
would be free choice of health care providers under a single
payer universal health care system, unlike our current managed
care system in which people are forced to see providers on the
insurer's panel to obtain medical benefits. There would be no
management of care under a single payer system unlike the current
managed care system which mandates insurer pre-approval for services
thus undercutting patient confidentiality and taking health care
decisions away from the health care provider and consumer

Myth:
Universal Health Care Is Socialized Medicine And Would Be Unacceptable
To The Public

Single
payer universal health care is not socialized medicine. It is
health care payment system, not a health care delivery system.
Health care providers would be in fee for service practice, and
would not be employees of the government, which would be socialized
medicine. Repeated national and state polls have shown that between
60 and 75% of Americans would like a publicly financed, universal
health care system

http://www.hungeractionnys.org/health2a.htm

PHYSICIANS
FOR A NATIONAL HEALTH PROGRAM FAQ http://www.pnhp.org/facts/singlepayer_faq.php#socialized

OCTOBER
2006

MORE
THAN HALF OF AMERICANS DISSATISFIED WITH HEALTH COSTS

RICARDO ALONSO-ZALDIVAR, LA TIMES
-
The annual Health Confidence Survey, released by the nonpartisan
Employee Benefit Research Institute, found that more than half
of those surveyed  52%  were dissatisfied with health
insurance costs, a sharp increase from 33% last year. . .

Retirement
plans took a big hit, with 36% of those who reported higher costs
over the last year saying they had reduced their contributions
to 401(k) plans. Of that group, 28% said that because of health-related
costs, they had trouble paying for such basic necessities as
housing, heat and food. . . The institute's poll found that workers
regard their employer-sponsored coverage as an ever more valuable
benefit, even as many new jobs come with no coverage and employers
cut back or drop existing plans.

QUARTER
OF AMERICANS SAY THEY OR FAMILY PUT OFF MEDICAL TREATMENT BECAUSE
OF COST

KAISER
FOUNDATION - One in four Americans say that they or a family
member in their household had problems paying medical bills during
the past 12 months, according to a new poll conducted jointly
by ABC News, the Kaiser Family Foundation and USA Today. That's
the highest share of Americans reporting a problem paying medical
bills in a series of Kaiser surveys taken since 1997. Among those
reporting a problem this year, nearly seven in 10 have health
insurance.

- About
one in four (28%) Americans say that in the past year they or
a family member have put off medical treatment because of its
cost. Of those who delayed treatment, seven in 10 (70%) say that
the care was for a serious medical condition.

- Among
those with health insurance, most (60%) are worried about not
being able to afford coverage over the next few years, with 27%
saying they are very worried.

- More
than half (54%) of those without health coverage say the main
reason is because they can't afford it, while another 15% say
they can't get it due to poor health, illness or age. In comparison,
just 4% say the main reason they lack health insurance is because
they think they don't need it.

- Eight
in 10 Americans (80%) say they are dissatisfied with the overall
cost of health care to the nation. When asked about their own
concerns about the health care system, cost comes out far ahead
of quality. Four in 10 say that they are dissatisfied with their
personal health care costs, compared with one in 10 who say they
are dissatisfied with the quality of their health care.

JULIE APPLEBY, USA TODAY - Fifty-six percent
say they would prefer universal coverage to the current system.
. . In the survey, 68% said providing coverage for everyone is
more important than keeping taxes down. . .

When survey
respondents were asked about possible trade-offs that might come
with a universal program, positive responses plummeted. The poll
found:

76% would
oppose universal coverage if it meant some medical treatments
currently covered by insurance would no longer be covered.

68% would
be against it if it led to limits on the choice of doctors.

DEAN BAKER,
PROSPECT - USA Today had an article this morning on rising U.S.
health care costs. It never mentions the fact that the United
States pays more than twice as much per person as the average
among other wealthy countries, yet has shorter life expectancies.

SURVEY
RESULTS
http://www.kff.org/kaiserpolls/pomr101606pkg.cfm

SEPTEMBER
2006

LACK
OF HEALTH ISURANCE KILLS SIX TIMES AS MANY AMERICANS EACH YEAR
AS 9/11 DID

SARAH
RUTH VAN GELDER AND DOUG PIBEL, YES MAGAZINE - An estimated 50
million Americans lack medical insurance, and a similar and rapidly
growing number are underinsured. The uninsured are excluded from
services, charged more for services, and die when medical care
could save them -- an estimated 18,000 die each year because
they lack medical coverage. But it's not only the uninsured who
suffer. Of the more than 1.5 million bankruptcies filed in the
U.S. each year, about half are a result of medical bills; of
those, three-quarters of filers had health insurance.

Employers
who want to offer employee health care benefits can't compete
with low-road employers who offer none. Nor can they compete
with companies located in countries that offer national health
insurance. . .

Among
politicians and pundits, a universal, publicly funded system
is off the table. . . The United States leaves the health of
its citizens at the mercy of an expensive, patchwork system where
some get great care while others get none at all. The overwhelming
majority -- 75 percent, according to an October 2005 Harris Poll
-- want what people in other wealthy countries have: the peace
of mind of universal health insurance.

http://www.alternet.org/stories/42011/

PORTLAND
PRESS HERALD - Patricia LaMarche, the Green Independent candidate
in Maine's five-way race for governor, proposed a state-run universal
health-care plan Thursday that would tax employers to pay for
the program. . . [The] program would have no co-pays, no deductibles
and no out-of-pocket expenses for essential care. Elective procedures
would not be covered. . . Her plan, which has been described
as the cornerstone of her campaign, would impose a payroll tax
of 5 percent to 12 percent on employers, depending on the size
of their work force. Employers with no more than five workers
would pay atax equivalent to 5 percent of their payroll. The
rate would rise gradually as the number of employees increased,
hitting a maximum of 12 percent, for employers with more than
1,000 workers. State, county and municipal governments also would
be taxed, and their employees would be covered by the plan. Providers
would bill a state-appointed Maine Healthcare Authority, which
would pay the bills. . . . LaMarche said her plan would seek
a federal waiver to let state government roll Medicaid funds
into the new program, but it would not alter the Medicare program
for the elderly.

JULIE APPLEBY, USA TODAY - Workers and employers
won't find much comfort in the smallest increase in health insurance
costs since 1999. The 7.7% increase this year is still more than
twice the rate of inflation. And those rising costs have so far
failed to boost the percentage of employers offering what are
touted by some, including President Bush, as an answer to health
care inflation: high-deductible insurance policies coupled with
savings accounts. Despite being the biggest buzz among benefit
consultants, the Kaiser Family Foundation says only 7% of employers
offered such policies this year, unchanged from 2005. The results
come from the non-profit foundation's annual employer survey,
released Tuesday. . . The total premium increase is up 87% since
2000.

MEDICAL
NEWS TODAY - Of working-age U.S. residents who sought individual
health coverage in the last three years, 89% were rejected for
medical reasons or felt that the available plans were unaffordable,
according to a study released Thursday by the Commonwealth Fund,
the Los Angeles Times reports. . . According to the survey, 58%
of respondents who applied for individual coverage found the
health plans unaffordable. Twenty-one percent of those who sought
individual coverage were rejected, charged a higher premium or
were offered a policy that excluded coverage for a specific health
condition they had. The study also finds: Two in five people
with individual coverage spend at least 5% of their incomes on
premiums, compared with one in seven who have employer-sponsored
coverage. More than half of people with individual coverage pay
at least $3,000 annually in premiums, and about one-third paid
at least $6,000 annually. One-third of people with individual
coverage have to pay $1,000 out-of-pocket each year before coverage
takes effect;

MORE
ADULT CHILDREN RELYING ON PARENTS' HEALTH INSURANCE

JENNIFER
8. LEE, NY TIMES - With 18- to 34-year-olds the fastest growing
group of uninsured, states are extending the time that children
can be a dependent for insurance purposes. In New Jersey, which
this year enacted the highest age limit, children can "piggyback"
until they turn 30, as long as they live in the state and don't
have their own children. The trend stems from a concern that
a healthy - and profitable - segment of the population is dropping
out of the insurance pool. About half of all states have studied
such proposals, and at least nine have passed laws, eight of
them since 2003 and three just this year, according to the National
Conference of State Legislatures.

KIM DIXON,
REUTERS - Most U.S. employers are planning to further scale back
health benefits offered to retirees, as companies struggle with
the upward march in the cost of medical care and weigh increased
contributions from government's Medicare program, a survey found.
Ninety-five percent of the mostly Fortune 500 companies polled
expect to further restrict their retiree health plans over the
next five years, and 14 percent plan to stop providing coverage
entirely, the survey of 163 companies by benefits consultants
Watson Wyatt found. Employers have been exiting the retiree health
business for a decade-and-a-half. . .

About
a third of U.S. employers offered current workers retiree coverage
in 2005, down from about two-thirds in 1988, according to a recent
study by the nonprofit Kaiser Family Foundation.

MAY
2006

A DOCTOR
COMES TO LIKE SINGLE PAYER

BENJAMIN
BREWER, MD - It took me a while to conclude that a single-payer
health system was the best approach. My fear had been that government
would screw up medicine to the detriment of my patients and my
practice. If done poorly, the result might be worse than what
I'm dealing with now.

But increasingly
I've come to believe that if done right, health care in America
could be dramatically better with true single-payer coverage;
not just another layer -- a part D on top of a part B on top
of a part A, but a simplified, single payer that would cover
all Americans, including those who could afford the best right
now. Representatives and senators in Washington should have to
use the same system my patients and I do were they to vote it
in.

Doctors
in private practice fear a loss of autonomy with a single-payer
system. After being in the private practice of family medicine
for 8 1/2 years, I see that autonomy is largely an illusion.
Through Medicare and Medicaid, the government is already writing
its own rules for 45% of the patients I see.

The rest
are privately insured under 301 different insurance products
(my staff and I counted). The companies set the fees and the
contracts are largely non-negotiable by individual doctors.

The amount
of time, staff costs and IT overhead associated with keeping
track of all those plans eats up most of the money we make above
Medicare rates. As it is now, I see patients and wait between
30 and 90 days to get paid. My practice requires two full-time
staff members for billing. My two secretaries spend about half
their time collecting insurance information. Plus, there's $9,000
in computer expenses yearly to handle the insurance information
and billing follow up. I suspect I could go from four people
in the paper chase to one with a single-payer system.

It would
be simpler and better for the patient, and for me, if the patient
could choose a doctor, bring their ID card with them, swipe it
in a card reader at the time of service and have the doctor get
paid on the spot with electronic funds transfer.

Instead,
patients have to negotiate a maze of deductibles, provider networks,
out-of-network costs, exclusions, policy riders, ER surcharges,
etc. Wouldn't a card swipe be simpler? No preexisting conditions
to worry about. No indecipherable hospital bills. One formulary
to deal with and one set of administrative rules to learn instead
of 300.

With a
single-payer system, there are concerns about waiting times for
procedures and not getting access to the "best doctors."
These are real issues, but not unsolvable ones. We have these
disparities now. Fact is, they are mostly a matter of geography,
insurance status and personal wealth.

A single-payer
system would increase access to care for the uninsured and the
underinsured, including the working poor. It would lower total
health costs, in part by replacing 50 different state Medicaid
programs and umpteen insurers with one system. This approach
has the potential to improve quality and lower costs by improving
care for chronic illnesses such as diabetes, high blood pressure
and heart disease. . .

I used
to think a single-payer system would keep my income down and
inject bureaucracy into my medical decision-making. But with
the efficiency it could bring, it would at worst be an economic
wash; more likely, the trimmed costs would more than make up
for any foregone revenue. As for autonomy, I'm already struggling
to maintain it amid the interference of insurers.

[Benjamin
Brewer is a doctor with a family practice in the rural village
of Forrest, Il]

http://online.wsj.com/article/SB114528925682927634.html

BUSH
HAS MORE THAN DOUBLED COST OF MEDICARE IN COVERT ATTACK ON PLAN

BLOOMBERG
- The U.S. Medicare plan will ask elderly people to pay 11 percent
more in health-insurance premiums for doctors' visits next year,
the program's trustees said in a report released yesterday. Medicare
intends to charge a monthly premium of $98.20 in 2007, up from
$88.50 this year, the trustees said. The premium has more than
doubled from the $45.50 charged in 2000. The Senate Democrats
yesterday said they want to peg the premium increases to the
Consumer Price Index, a measure used to track economic growth,
to slow rate hikes.

http://tinyurl.com/ltzw6

APRIL
2006

MIDDLE
CLASS WITHOUT HEALTH INSURANCE SOARING

NICK TIMIRAOS, LA TIMES - The number
of uninsured adults who earn between $20,000 and $40,000 annually
is rising, according to a study released today - suggesting that
fewer employers are providing healthcare coverage. That study,
along with one that says the uninsured are likely to seek treatment
only when they become seriously ill, coincides with a national
campaign, Cover the Uninsured, to make healthcare coverage a
top legislative priority.

Research
by the Commonwealth Fund, a nonpartisan New York-based foundation
that examines healthcare issues, found that the percentage of
moderate-income Americans who were without insurance for at least
part of the year had jumped sharply over four years - from 28%
in 2001 to 41% in 2005.

ROMNEY
HEALTHCARE PLAN IS A CON

STEFFIE
WOOLHANDLER AND DAVID HIMMELSTEIN, PHYSICIANS FOR A NATIONAL
HEALTH PROGRAM - The politicians assumed that only about 500,000
people in Massachusetts are uninsured. The Census Bureau says
that 748,000 are uninsured. Why the difference? The 500,000 figure
comes from a phone survey conducted in English and Spanish. Anyone
without a phone or who speaks another language is counted as
insured. The 748,000 figure comes from a door-to-door survey
carried out in many languages (including Portuguese and Haitian
Creole, common languages in Massachusetts). In sum, the reform
plan wishes away 248,000 uninsured people who don't have phones
or don't speak English or Spanish. It provides no funding or
means to get them coverage.

Second,
the linchpin of the plan is the false assumption that uninsured
people will be able to find affordable health plans. A typical
group policy in Massachusetts costs about $4500 annually for
an individual and more than $11,000 for family coverage. A wealthy
uninsured person could afford that &SHY; but few of the uninsured
are wealthy. A 25 year old fitness instructor can find a cheaper
plan. But few of the uninsured are young and healthy. According
to Census Bureau figures, only 12.4% of the 748,000 uninsured
in Massachusetts are both young enough to qualify for low-premium
plans (under age 35) and affluent enough (incomes greater than
499% of poverty) to readily afford them. Yet even this 12.4%
figure may be too high if insurers are allowed to charge higher
premiums for persons with health problems; only half of uninsured
persons in those age and income categories report that they are
in "excellent health".

The legislation
promises that the uninsured will be offered comprehensive, affordable
private health plans. But that's like promising chocolate chip
cookies with no fat, sugar or calories. The only way to get cheaper
plans is to strip down the coverage &SHY; boost co-payments,
deductibles, uncovered services etc.

Hence,
the requirement that most of the uninsured purchase coverage
will either require them to pay money they don't have, or buy
nearly worthless stripped down policies that represent coverage
in name only.

Third,
the legislation will do nothing to contain the skyrocketing costs
of care in Massachusetts &SHY; already the highest in the world.
Indeed, it gives new infusions of cash to hospitals and private
insurers. Predictably, rising costs will force more and more
employers to drop coverage, while state coffers will be drained
by the continuing cost increases in Medicaid. Moreover, when
the next recession hits, tax revenues will fall just as a flood
of newly unemployed people join the Medicaid program or apply
for the insurance subsidies promised in the reform legislation.
The program is simply not sustainable over the long &SHY; or
even medium &SHY; term.

What Are
the Alternatives?

A single
payer universal coverage plan could cut costs by streamlining
health care paperwork, making health care affordable. Massachusetts
Blue Cross spends only 86% of premiums paying for care. It spends
the rest - more than $700 million last year - on billing, marketing
and other administrative costs. Harvard Pilgrim and Tufts Health
Plan &SHY; our other big insurers - are little better; each took
in about $300 million more than it paid out. That's ten times
as much overhead per enrollee as Canada's national health insurance
program. And our hospitals and doctors spent billions more fighting
with insurers over payments.

Overall,
Massachusetts residents will spend $13.3 billion on health care
bureaucracy this year &SHY; nearly one third of our total health
bill. If we cut bureaucracy to Canada's levels we could save
$9.4 billion annually, enough to cover all of the 748,000 uninsured
in Massachusetts and to improve coverage for the rest of us.

Study
after study &SHY; by the Congressional Budget Office, the General
Accounting Office and even the Massachusetts Medical Society
- have confirmed that single payer is the only route to affordable
universal coverage.

And single
payer is popular. The Massachusetts Nurses Association supports
it along with dozens of other labor, seniors and consumer groups;
so do 62% of Massachusetts physicians according to a recent survey.
National polls find that almost two-thirds of Americans favor
a tax-funded plan like Medicare that would cover all Americans.

But single
payer national health insurance threatens the multi-million dollar
paychecks of insurance executives, and the outrageous profits
of drug companies and medical entrepreneurs.

http://www.pnhp.org

MARCH
2006

FIVE
MYTHS ABOUT NATIONAL HEALTHCARE

[Tyler
Zimmer, Campus Progress]

Myth #1:
It would be too expensive

UHC would
actually reduce the cost of health care. The Congressional Budget
Office estimated that UHC could save up to $14 billion annually
by spreading the risk evenly over the entire population, eliminating
deductibles and co-pays and making preventive medicine available
to the poor and uninsured. The federal government already subsidizes
private health insurance in the form of tax deductions.

Private
insurance companies also spend billions on administration and
overhead, advertising, and determining and inspecting patient
eligibility, all while trying to make a profit. UHC would not
be burdened with some of those costs, like advertising, and unlike
private business, it could run at a loss and still be viable.
. .

Myth #2:
It would require a huge, inefficient bureaucracy

The current
system is already a huge, inefficient bureaucracy! As previously
mentioned, much of the unnecessary overhead and micromanaging
in the system now could be eliminated if UHC were implemented.
For example, the bureaucracy and paperwork involved in determining
patient eligibility would be completely unnecessary if everyone
were eligible and covered. Insurance companies spend an estimated
25 cents of every dollar on administration. Canada, which already
has a comprehensive UHC in place and still manages to pay 70
percent less per citizen on health care, spends about the equivalent
of about 12 cents of every dollar on administration.

Myth #3:
It would restrict patient choice

UHC wouldn't
directly dictate what doctor you have to see in order to get
treatment and would thus enable more choice in selecting a physician
than the current system would for many, if not most, Americans.

Myth #4:
It would be a socialist seizure of the medical industry

It would
be nothing of the sort. Socialized medicine would entail hospitals
and doctors becoming employees of the state. UHC only provides
funding for people's health care, but doesn't provide the health
care itself. . . UHC would be no more socialist than Medicare
and arguably less so than public education.

Myth #5:
UHC would impede economic growth

An added
benefit of UHC would be that private business would no longer
have to worry about health-care benefits, and employees wouldn't
have to remain in unpleasant jobs just to keep their benefits.
Benefits wouldn't interfere with wage increases, and employers
would have more financial mobility. . .

http://www.alternet.org/wiretap/31196/

MEDICARE
DRUG PLAN IS BIGGEST GOVERNMENT LEGISLATIVE FRAUD SINCE THE S&L
BAILOUT

PROGRESSIVE
REVIEW - The new Medicare drug plan is probably the biggest government
fraud since the S&L bailout. And as with the savings and
loan scandal, the media is simply going along with it, reporting
what is massive giveaway to the drug corporations as just another
government program. It isn't: the measure was specifically designed
the give the drug industry the biggest profits possible with
Medicare recipients the ultimate victims. It was deliberately
written to confuse, obscure and complicate use of the benefits.
Name one other such widely used federal program where you have
to go to a two hour workshop just to find out what the hell is
going on. Name one other with a permanent continuing penalty
attached to those who fail to sign up by a certain time. Name
one other with such a bewildering set of choices for no good
purpose other than to let the big corporations make more money.

Here for
example, are just two paragraphs from an attempt in the Texasrkanan
Gazette to explain the program to its readers:

"For
example, your prescriptions costs now run about $100 per month.
You could choose a plan with a '0' monthly premium and a $250
yearly deductible. You would have met your deductible in less
than three months. The rest of the year, you would have no expense
other than the amount your plan charges for your prescription.
Spending no more than $100 per month or less on prescriptions,
you will never reach the $3,600 out of pocket expenses and the
catastrophic coverage.

"On
the other hand, your prescription costs run $1,500 per month.
You choose a plan with a $250 deductible and a '0' or low monthly
premium. You will have reached your $250 deductible the first
month and $3,600 "out of pocket expense" by the third
month. Your prescriptions would then cost no more than $2 for
generics and $5 for brand names."

This measure
joins the S&l bailout and a few others as legislation which
by its very nature borders on criminal intent, a deliberate effort
to defraud the those who were meant to benefit from it.

THE
ISSUE THE MEDIA REFUSES TO ADDRESS

ROBERT
KUTTNER, BOSTON GLOBE - Health insurance is the most vivid case
of what political scientist Walter Dean Burnham calls a ''politics
of excluded alternatives." Polls consistently show that
over two-thirds of Americans want universal tax-supported health
insurance. Gallup found that 79 percent of Americans want coverage
for all, and 67 percent don't mind if taxes are raised to pay
for it. Fully 78 percent are dissatisfied with the present system.
Medicare, the one part of the system that is true national health
insurance (for seniors) is overwhelmingly popular.

There
is no hotter political issue, nor one that strikes closer to
home. So, if Americans overwhelmingly want national health insurance,
why don't we get it? Three huge reasons: political, fiscal, and
jurisdictional.

Politically,
the immensely powerful private insurance industry would be displaced
by national health insurance. Nearly all corporations would rather
suffer with the devil that they know (escalating premiums) than
the devil they hate (an expanded role for government). Ideologically,
something supported by overwhelming majorities is seen as radical.
(So was Social Security until it was enacted).

http://www.commondreams.org/views05/1126-26.htm

MEDICARE
DRUG PLAN CUTS OFF AID TO THE NEEDY

THOMAS GINSBERG, KNIGHT RIDDER
-
Under federal rules effective Jan. 1, low-income and elderly
patients who enroll in the program, known as Medicare Part D,
will lose the ability to get free medications through the drugmakers'
tax- deductible charities, known as patient- assistance programs.
Some companies, going further, said this week that they would
drop patients who were merely eligible for Part D, whether or
not they actually enrolled in it, as allowed under longstanding
rules. As a result, in about six weeks, up to half of the roughly
3 million to 4 million charity patients nationwide may lose free
access to more than 1,200 brand-name drugs, according to estimates
of three companies. Other recipients should be unaffected. .
. News of the cutoff followed a ruling last week by the Inspector
General of the Department of Health and Human Services barring
companies from giving free drugs to Part D enrollees, hoping
to prevent fraud. While suggesting an alternative charity system,
the ruling threw a confusing twist into the already-baffling
Medicare prescription-drug program. ''The last thing we need
is one more variable in a hopelessly complex situation,"
said Robert M. Hayes, president of the Medicare Rights Center,
an advocacy group based in New York. On Tuesday, Americans could
begin to sign up for the new voluntary Medicare prescription-drug
coverage. About 42 million Medicare recipients are eligible for
the program.

LEAVE
NO SENIOR UNSTYMIED ACT CONT'D

USA TODAY
- Using the Medicare drug-benefit search tool requires patience.
With a high-speed Internet link, allow at least 20 minutes to
do a simple search:

2. Enter
a Medicare member's number or select the general search button
and type in a ZIP code to find all the plans serving a region.
You may get a long list.

3. Narrow
the selection by entering the names of the prescription drugs
taken by the Medicare member. You can enter exact dosages or
click a button that will enter commonly prescribed dosages for
you. Keep in mind that the list that results includes plans that
may not cover all the drugs you've chosen.

4. Compare
plans on cost, deductible, premium and other factors by selecting
up to three plans at a time and clicking on the compare button.
Choose several options that look appealing and print out the
list of your selections for later reference.

5. Go
back to the main home page. Select the link to "Formulary
Finder."

6. Enter
your state and re-enter all the drug names. You'll get two lists
of plans. The list at the top of the page shows plans that cover
all your selected drugs. The second list at the bottom shows
plans that cover only some of the drugs.

7. Refer
to the printout of choices you're considering in your ZIP code.
By clicking on the plan names, you can learn more about the drugs
covered by each plan and what restrictions, if any, are placed
on them.

[This,
mind you, only gives a list of drug merchants who may offer some
but not all of the drugs a senior may need]

SENIORS
JOIN CHILDREN IN BEING LEFT BEHIND BY BUSH REGIME

ROBERT
PEAR, NY TIMES Enrollment in the new Medicare drug benefit begins
in three days, but even with President Bush hailing the plan
as "the greatest advance in health care for seniors"
in 40 years, large numbers of older Americans appear to be overwhelmed
and confused by the choices they will have to make. At a senior
center in Urbana, Lynn Heskett of the Ohio Senior Health Insurance
Information Program described the drug plan to a full house.
"I have a Ph.D., and it's too complicated to suit me,"
said William Q. Beard, 73, a retired chemist in Wichita, Kan.,
who takes eight prescription drugs, including several heart medicines.
"I wonder how the vast majority of beneficiaries will handle
this. . .

"The
whole thing is hopelessly complicated," said Pauline H.
Olney, 74, a retired nurse who attended a seminar at a hotel
in Santa Rosa, north of San Francisco. . .

In most
states, beneficiaries have a choice of more than three dozen
prescription drug plans. Premiums, deductibles, co-payments and
covered drugs vary widely. Many retirees also have other options:
getting drug coverage through former employers or through Medicare-managed
care plans. In Kansas, Medicare beneficiaries have a choice of
40 prescription drug plans charging premiums from $9.48 a month
to $67.88 a month. . .

http://www.nytimes.com/2005/11/13/national/13drug.html

PAUL KRUGMAN,
NY TIMES - At first, the benefit will look like a normal insurance
plan, with a deductible and co-payments. But if your cumulative
drug expenses reach $2,250, a very strange thing will happen:
you'll suddenly be on your own. The Medicare benefit won't kick
in again unless your costs reach $5,100. This gap in coverage
has come to be known as the "doughnut hole." . . .

One way
to see the bizarre effect of this hole is to notice that if you
are a retiree and spend $2,000 on drugs next year, Medicare will
cover 66 percent of your expenses. But if you spend $5,000 -
which means that you're much more likely to need help paying
those expenses - Medicare will cover only 30 percent of your
bills. A study in the July/August issue of Health Affairs points
out that this will place many retirees on a financial "roller
coaster."

http://select.nytimes.com/2005/11/11/opinion/11krugman.html?hp

AMERICANS
PAY MORE, GET LESS HEALTH CARE

MARGUERITE HIGGINS, WASHINGTON
TIMES -
Out-of-pocket medical expenses and medical errors were higher
for patients in the United States than for those in countries
that have state-funded health care systems, according to a new
report. The study, which was released yesterday by the Commonwealth
Fund, surveyed nearly 7,000 patients from March to June in the
United States, Britain, Canada, Australia, Germany and New Zealand.
Roughly 34 percent of U.S. patients encountered a medical mistake
in the past two years, followed by 30 percent of Canadian patients,
said the New York health research organization, which promotes
universal health care coverage through government and corporate
initiatives. . .

Additionally,
34 percent of U.S. patients paid more than $1,000 in out-of-pocket
medical expenses in the past year while only 14 percent of Canadian
and Australian patients paid that much in the same period, the
report said.

ROB STEIN WASHINGTON POST - "What's
striking is that we are clearly a world leader in how much we
spend on health care," said Cathy Schoen, senior vice president
for the Commonwealth Fund, a private, nonpartisan, nonprofit
foundation that commissioned the survey. "We should be expecting
to be the best. Clearly, we should be doing better." Other
experts agreed, saying the results offer the most recent evidence
that the quality of care in the United States is seriously eroding
even as health care costs skyrocket. "This provides confirming
evidence for what more and more health policy thinkers have been
saying, which is, 'The American health care system is quietly
imploding, and it's about time we did something about it,' "
said Lucian L. Leape of the Harvard School of Public Health.

OCTOBER
2005. . .

THE
FAILURES OF HEALTH INSURANCE

JOHN LELAND,
NY TIMES - After decades in which private and government insurance
covered a progressively larger share of medical expenses, insurance
companies are now shifting more costs to consumers, in the form
of much higher deductibles, co-payments or premiums. At the same
time, Americans are saving less and carrying higher levels of
household debt, and even insured families are exposed to medical
expenses that did not exist a decade ago. . . Lawyers and accountants
say that for the more than 1.5 million American families who
filed for bankruptcy protection last year, the most common causes
were job loss and medical expenses. New bankruptcy legislation,
which went into effect Oct. 17, requires middle-income debtors
to repay a greater share of their debt.

http://www.nytimes.com/2005/10/23/national/23PATIENT.html

SEPTEMBER
2005.
. .

NUMBER
WITHOUT HEALTH INSURANE RISING

BOSTON GLOBE - With the exception
of 1999 and 2000, the number of Americans without health insurance
has risen steadily from just over 30 million in 1987. It is a
bipartisan failure. After President Clinton dropped his botched
attempt for a more universal form of healthcare in his first
term, the numbers of the uninsured soared from 35 million to
nearly 45 million. Aided by a booming economy, the numbers fell
in Clinton's last two years to 40 million. Under Bush, the number
cracked the 45 million barrier for the first time -- 45.8 million,
to be exact.

WHY
SMALL BUSINESSES SHOULD BE LOOKING AT NATIONAL HEALTHCARE

SMALL
BUSINESS TIMES - Health care costs are rising at 10-15% per year
and employers are struggling for ways to pay these costs, which
typically represent 15% of their labor costs. Many are shifting
the costs to their employees by demanding high deductibles and
co-pays, and in some cases contracting with HMOs who make their
money more by denying care than providing it.

But what
else can companies do? They are competing with manufacturers
in countries that have taxpayer-paid universal health care systems,
and these competitors need not add health care to the cost of
their products. Of course our manufacturers can send their work
abroad, but then American jobs are lost.

Rising
health care costs are the result of only one thing, a medical
community that has switched from being humanitarian medical centers
to for-profit corporations. The industry has run amok. They are
inefficiently operated and they love it, because inefficiency
is where they make much of their profits. Medicare and private
insurers are incurring 20% to 30% of their costs from unnecessary
and inappropriate medical testing, and another 30% in exorbitant
administrative waste. Compare that 30% to Canada's 8% and Medicare's
3.5%. Wisconsinites are supporting 400 for-profit insurance companies
compared to the ONE non-profit contractor in each Canadian province.

The 30%
waste is not exclusive to government systems; it also exists
within the private sector. It is the profit motive that is driving
up health care costs, and this motivation exists on all fronts:
hospitals, physicians and insurers, including for-profit HMOs.
For-profit entities are obligated by law to seek the highest
profits possible for their shareholders, and cutting care helps
achieve this goal.

The United
States and South Africa are the only two industrialized countries
that do not have universal health care for their citizens. Over
45 million Americans, 15% of our population, are totally without
health care and just show up at the emergency room for treatment,
which is the most expensive form of rationing possible. The E.R.
charges sometimes force them into bankruptcy, where the losses
are shifted to those who are insured or to the taxpayers. Over
18,000 Americans die prematurely every year because they lack
coverage - which is six times more than died on 9/11. Another
50 million Americans are underinsured and are a mishap away from
bankruptcy and the societal costs that result.

Why do
we allow this? Because our politicians are paid to allow it:
it's called "$100 million per year in political contributions
given by our health care and pharmaceutical industries."
Political money got us into this mess and eliminating political
money will be the only way of getting us out of it. Unless, of
course, business leaders force the issue and demand change.

AMERICA'S
TRAGIC HEALTH RECORD

PAUL VALLELY,
INDEPENDENT, UK - Parts of the United States are as poor as the
Third World, according to a shocking United Nations report on
global inequality. The US is the only wealthy country with no
universal health insurance system. . .

The annual
Human Development Report normally concerns itself with the Third
World, but the 2005 edition scrutinizes inequalities in health
provision inside the US as part of a survey of how inequality
worldwide is retarding the eradication of poverty. It reveals
that the infant mortality rate has been rising in the US for
the past five years - and is now the same as Malaysia. America's
black children are twice as likely as whites to die before their
first birthday. . .

http://www.commondreams.org/headlines05/0908-06.htm

AUGUST
2005.
. .

HEALTH
BILLS LEADING CAUSE OF BANKRUPTCY

MALCOLM
GLADWELL, NEW YORKER - The leading cause of personal bankruptcy
in the United States is unpaid medical bills. Half of the uninsured
owe money to hospitals, and a third are being pursued by collection
agencies. Children without health insurance are less likely to
receive medical attention for serious injuries, for recurrent
ear infections, or for asthma. Lung-cancer patients without insurance
are less likely to receive surgery, chemotherapy, or radiation
treatment. Heart-attack victims without health insurance are
less likely to receive angioplasty. People with pneumonia who
don't have health insurance are less likely to receive X rays
or consultations. The death rate in any given year for someone
without health insurance is twenty-five per cent higher than
for someone with insurance. Because the uninsured are sicker
than the rest of us, they can't get better jobs, and because
they can't get better jobs they can't afford health insurance,
and because they can't afford health insurance they get even
sicker.

http://www.newyorker.com/fact/content/articles/050829fa_fact

JULY
2005 .
. .

U.S
SPENDS DOUBLE ON HEALTHCARE COMPARED TO 29 INDUSTRIALIZED NATIONS

ST PETERSBURG
TIMES - America's fragmented health care system is the costliest
in the world. The latest study, conducted by Johns Hopkins University
researchers and reported this month in Health Affairs, offers
more evidence of the same. The United States spent $5,267 per
person on health care in 2002. That's more than double, per capita,
what 29 other industrialized nations spent. The total amounts
to 14.6 percent of the U.S. gross domestic product. The United
Kingdom, by comparison, spent 7.7 percent.

http://sptimes.com/2005/07/16/Opinion/The_wrong_Rx.shtml

MAY
2005.
. .

IT'S
INSURANCE FEES, NOT AWARDS, THAT ARE COSTING DOCTORS

LIZ KOWALCZYK, BOSTON GLOBE Re-igniting the
medical malpractice overhaul debate, a new study by Dartmouth
College researchers suggests that huge jury awards and financial
settlements for injured patients have not caused the explosive
increase in doctors' insurance premiums. The researchers said
a more likely explanation for the escalation is that malpractice
insurance companies have raised doctors' premiums to compensate
for falling investment returns.

The Dartmouth
economists studied actual payments made to patients between 1991
and 2003, the results of which were published yesterday in the
journal Health Affairs. Some previous studies have examined jury
awards, which often are reduced after trial to comply with doctors'
insurance coverage maximums or because the plaintiff settles
for less money to avoid an appeal. Researchers found that payments
grew an average of 4 percent annually during the years covered
by the study, or 52 percent overall since 1991, but only 1.6
percent a year since 2000. The increases are roughly equivalent
to the overall rise in healthcare costs, said Amitabh Chandra,
lead author and an assistant professor of economics at the New
Hampshire college.

AMERICA'S
LOUSY HEALTHCARE

RICHARD
SCHWARTZ, NY DAILY NEWS - America doesn't have the world's best
health care system, just the most expensive. For those of you
who worry about your health and wealth (i.e., everyone), that's
mind-bogglingly bad news. The numbers are grotesque. The United
States spends 15.5 percent of its gross domestic product on health
care, about $1.7 trillion a year. No other country comes close.
Yet for all that money - equal to the entire economic output
of France - 45 million Americans go without health insurance.

By the
way, in France, which on a per-capita basis spends about half
what we do on health care, everyone is insured. In fact, under
France's universal health system, patients can visit doctors,
even specialists, virtually any time they wish. . .We're only
No. 22 among industrialized nations in life expectancy (77 years).
Japan is No. 1 at 81 years. We're No. 25 in infant mortality
rate (6.8 infant deaths per 1,000 births). Sweden leads with
only 3.5 deaths per 1,000. .
PROGRESS REPORT - In a study conducted by the Robert Wood Johnson
Foundation, 41 percent of uninsured adults said they were unable
to see a doctor when they needed to during the previous year
and 56 percent did not have a personal doctor or other health
care provider. In 2003, chronically ill uninsured adults were
more than four times more likely to go without medical care or
prescription drugs than chronically ill insured adults."
Nevertheless, more than one in five uninsured adults with chronic
conditions report spending at least $2,000 out of pocket in a
year for medical care. In last week's Los Angeles Times, Barbara
Ehrenreich pointed out the "average visit to an ER now costs
a little over $1,000, which is a high price to pay for an asthma
attack or an infant's fever."

RWJF estimates
that 20 million working Americans are uninsured and the Washington
Times reports rising health care costs are forcing companies
to pass "more of their health care costs on to employees
in an effort to cut business expenses." General Motors Corp.,
the nation's largest buyer of health plans, recently reported
it lost $1.1 billion in the first quarter of 2005, its largest
quarterly loss in more than a decade." The company "cited
the cost of providing health coverage for its workers and retirees
as a main culprit."

The first
element of the Bush administration's response to America's health
care crisis has been to cut funding for coverage and offer half-baked
privatization plans like Health Savings Accounts that exacerbate
existing problems and would help only 0.3 percent of uninsured
adults. In his latest "victory," President Bush successfully
lobbied Congress to cut federal funding for Medicaid, the nation's
largest insurance program for the poor. Medicaid was already
facing increased costs driven by "enrollment growth due
to the economic downturn" during Bush's first term. In addition,
Congress recently passed the White House-backed Bankruptcy Bill,
which will make it harder for uninsured Americans to recover
from crippling debt brought on by medical problems.

The second
part of the Bush administration's response appears to involve
pretending health care problems don't exist. For instance, the
2004 Economic Report of the President concluded "many [of
the uninsured] may remain uninsured as a matter of choice,"
perhaps because "they are young and healthy and do not see
the need for insurance." Others, the report offered, are
probably covered but do not report it, maybe because the "survey
questions are confusing." A more recent report funded by
the Department of Health and Human Services set out to prove
the number of uninsured is overstated

APRIL
2005

PAUL KRUGMAN,
NY TIMES - In 2002, the latest year for which comparable data
are available, the United States spent $5,267 on health care
for each man, woman and child. Of this, $2,364, or 45 percent,
was government spending, mainly on Medicare and Medicaid. Canada
spent $2,931 per person, of which $2,048 came from the government.
France spent $2,736 per person, of which $2,080 was government
spending. . .

U.S. health
care is so expensive that our government spends more than the
governments of other advanced countries, even though the private
sector pays a far higher share of the bills than anywhere else.
. .

Most Americans
probably do not know that we have substantially lower life-expectancy
and higher infant-mortality figures than other advanced countries.
. . Social factors, notably America's high poverty rate, surely
play a role. Still, it seems puzzling that we spend so much,
with so little return.

A KAISER COMMISSION STUDY on Medicaid and
the uninsured study finds that uninsured Americans could incur
nearly $41 billion in uncompensated health care treatment in
2004, with federal, state and local governments paying as much
as 85 percent of the care. Even with uncompensated care, the
study shows that people uninsured for the entire year can expect
to receive about half as much care as people fully insured.

Another
major finding of the study, authored by Urban Institute researchers
Jack Hadley and John Holahan, is that if the country provided
coverage to all the uninsured, the cost of additional medical
care provided to the newly insured would be $48 billion - an
increase of 0.4 percent in health spending's share of the gross
domestic product.

DETAILS
OF THE CONYERS MEDICARE BILL

JOHN CONYERS
- The United States National Health Insurance Act (HR676) establishes
a new American national health insurance program by creating
a single payer health care system. The bill would create a publicly
financed, privately delivered health care program that uses the
already existing Medicare program by expanding and improving
it to all U.S. residents, and all residents living in U.S. territories.
The goal of the legislation is to ensure that all Americans,
guaranteed by law, will have access to the highest quality and
cost effective health care services regardless of one's employment,
income, or health care status.

With over
42 million uninsured Americans, and another 40 million who are
under insured, the time has come to change our inefficient and
costly fragmented health care system. The USNHI program would
reduce overall annual health care spending by over $50 billion
in the first year. In addition, because it implements effective
methods of cost-control, health spending is contained over time,
ensuring affordable health care to future generations.

In its
first year, single-payer will save over $150 billion on paperwork
and $50 billion by using rational bulk purchasing of medications.
These savings are more than enough to cover all the uninsured,
improve coverage for everyone else, including medication coverage
and long-term care.

Employers
who currently provide coverage for their employees pay an average
of 8.5% of payroll towards health coverage, while many employers
can't afford to provide coverage at all. Under this Act, all
employers will pay a modest 3.3% payroll tax per employee, while
eliminating their payments towards private health plans. The
average cost to an employer for an employee earning $35,000 per
year will be reduced to $1,155, less than $100 per month.

95% of
families will pay less for health care under national health
insurance than they do today. Seniors and younger people will
all have the comprehensive medication coverage they need.

Who is
Eligible

Every
person living in the United States and the U.S. Territories would
receive a United States National Health Insurance Card and i.d
number once they enroll at the appropriate location. Social Security
numbers may not be used when assigning i.d cards. No co-pays
or deductibles are permissible under this act.

Private
health insurers shall be prohibited under this act from selling
coverage that duplicates the benefits of the USNHI program. They
shall not be prohibited from selling coverage for any additional
benefits not covered by this Act; examples include cosmetic surgery,
and other medically unnecessary treatments.

Cost
Containment Provisions/ Reimbursement

The National
USNHI program will annually set reimbursement rates for physicians,
health care providers, and negotiate prescription drug prices.
The national office will provide an annual lump sum allotment
to each existing Medicare region, which will then administer
the program. Payment to health care providers include fee for
service, and global budgets.

The conversion
to a not-for- profit health care system will take place over
a 15 year period, through the sale of U.S. treasury bonds; payment
will not be made for loss of business profits, but only for real
estate, buildings, and equipment.

Funding
& Administration

The United
States Congress will establish annual funding outlays for the
USNHI Program through an annual entitlement. The USNHI program
will operate under the auspices of the Dept of Health & Human
Services, and be administered in the former Medicare offices.
All current expenditures for public health insurance programs
such as S-CHIP, Medicaid, and Medicare will be placed into the
USNHI program.

A National
USNHI Advisory Board will be established, comprised primarily
of health care professionals and representatives of health advocacy
groups.

Proposed
Funding For USNHI Program: $1.86 Trillion Per Year

A payroll
tax on all employers of 3.3%. Maintain employee and employer
Medicare payroll tax of 1.45%. Implement a variety of mechanisms
so that low and middle income families pay a smaller share of
their incomes for health care than wealthiest 5% of Americans;
i.e, a health income tax on the wealthiest 5% of Americans, a
small tax on stock and bond transfers, and closing corporate
tax shelters. A repeal of the Bush tax cut of 2001. For more
details, see PNHP's "Financing National Health Insurance."

CONSUMERS UNION REPORT FINDINGS: "The funds
set aside for this 'benefit' - $400 billion over 10 years - cover
just 22 percent of the anticipated drug costs, leaving consumers
to foot the rest of the bill.". . . "Medicare is being
moved down the road to privatization by requiring competition
between private health plans and Medicare". . . "Private
Pharmacy Benefit Managers get to pick what drugs are covered
under the plan, with no transparency, methodology or public accountability.
This means patients who are sensitive to the choice of drug will
be out of luck if their needed drug is not on the plan.".
. . The deal "actually prohibits the government from negotiating
deep prescription drug discounts for consumers, meaning the average
Medicare beneficiary will pay more out-of-pocket for drugs in
2007 when the benefit begins, than what they currently pay now
without the 'benefit.'"

DON McCANNE, M.D., PHYSICIANS
FOR A NATIONAL HEALTH PROGRAM - "The prescription drug
benefit fails miserably on its alleged purpose: making drugs
affordable for seniors. It provides a blank check for pharmaceutical
firms to continue to gouge seniors, and introduces the pharmacy
benefit manager middlemen who profit by taking away our choices
in drug access. Worse, the legislation provides financial incentives
for the healthy and wealthy to exit the traditional Medicare
program and enroll in private PPO plans. This concentrates high-cost,
chronically ill patients in the traditional program, driving
up program costs. When forced to compete with the private HMOs,
which will be subsidized, the higher costs will be shifted to
Medicare beneficiaries in the form of unaffordable premiums.
This 'death spiral' of ever-higher Medicare premiums will force
patients into the private plan marketplace. To keep premiums
affordable, the plans will strip out benefits and require unaffordable
cost sharing. Then Medicare will no longer ensure either health
security or financial security for our seniors."

JOHN HESS, HEALTH WRITER - "Once
again, the AARP has stabbed America's elderly in the back. For
more than 30 years now, it's been held up as a scarecrow - a
monster representing 35 million greedy geezers. . . Briefly,
the AARP is not a league of the elderly, but a marketing agency
with a shady past. It peddles insurance, travel, advertising,
and anything else it can get its hands on. It has a mailing list
- not a membership - of 35 million customers. If you turn 50,
they'll try to get your name on it. It calls itself an 'association'
and goes through the motions in an effort to dodge taxes and
commercial mailing rates, and it's been in constant trouble with
the IRS and the Postal Service."

SAM SMITH,
'SHADOWS OF HOPE,' 1994 - During the first months of the Clinton
administration, one of the biggest national policy changes of
the past fifty years was being forged by a secret committee led
by Mrs. Clinton under procedures that periodically defied the
courts and the Government Accounting Office and whose public
manifestations consisted of highly contrived media opportunities,
carefully staged "town meetings," and similar artifices.

Despite
the contrary evidence of public opinion polls, the concept of
Canadian-style single-payer insurance was dismissed early. Tom
Hamburger and Ted Marmor in the Washington Monthly tell of a
single-payer proponent being invited to the White House in February
1993. It was, he said, a "pseudo-consultation;" the
doctor was quickly informed that "single payer is not politically
feasible." When Dr. David Himmelstein of the Harvard Medical
School pressed Mrs. Clinton on single payer, she replied, "Tell
me something interesting, David."

In other
words, write Hamburger and Marmor: "Fewer than six weeks
into the Clinton presidency, the White House had made its key
policy decision: Before the Health Care Task Force wrote a single
page of its 22-volume report to the President, the single payer
idea was written off, and "managed competition" was
in."

If there
was any popular, grassroots demand for "managed competition"
it never appeared. Managed competition had not been tested anywhere.
Nonetheless, reported Thomas Bodenehimer in Nation:

"Around
Hillary Rodham Clinton's health reform table sit the managed-competition
winners: big business, hospitals, large (but not small) commercial
insurers, the Blues, budget-worried government leaders and the
'Jackson Hole Group,' the chief intellectual honchos of the managed
competition movement. . . Adherence to the mantra of managed
competition appears to be the price of a ticket of admission
to this gathering. "

What was
finally proposed involved a massive transfer of the American
health industry - by some accounts now larger than the military-industrial
complex - to a small number of the largest insurance companies
and other major corporations. These were companies that had the
assets to play the game being offered - a medical oligopoly that
would dispense health-care under the rules of the Fortune 500
rather than according to those of Hipprocrates.